CAPA Performing Arts Camp

March 11, 2017 at Churchill High School

Applications are due by February 23, 2017

( $25 cash or checks can be made out to: Churchill High School)  


Student Name: ___________________________________ Grade: ______

School: ________________________

Phone Contact name and number: _____________________________

Address: ___________________________________________________

E~mail address (please print legibly): _______________________________________


T-Shirt Size (adult sizes) :    S      M      L    XL   XXL


Area of Interest for the day:  (circle only one please)   Acting    Vocal    Dancing



Why do you want to be a part of the CAPA Performance Arts Camp?




Any food allergies? If yes, please list the allergy:


Workshop Rules:

  1. No student should be in the hallways or bathrooms without supervision.
  2. Mentors/adults will escort students to appropriate rooms (including bathroom breaks)
  3. Attendance will be taken in every session after breaks.
  4. CAPA will distribute snacks to rooms during break times and serve a pizza lunch to students. Students may also bring a bag lunch to the camp.
  5. In the event of an emergency, immediately find a CAPA staff member or volunteer (parents/guardians of the participants must be available by phone during the hours of the camp)
  6. Staff will stay with students until they are picked up at the end of the day, 3:00. A late fee of $5.00 will be charged for every 15 minutes after the designated pick up time of 3:00.
  7. Parent/Guardian must check their student in and out of the camp at the registration table before dropping off or picking up their student. Registration/check in begins at 8:30 a.m..
  8. Students will leave all valuables, including cell phones, at home. Phone service is available for students in case of emergency or to call home for a pick up.
  9. By signing below, both student and parent/guardian agree to the above workshop rules and verbal directions given by the camp staff.


_________________________                                  _______________

Student Signature                                                   Date


_________________________                                  _______________________________________

Parent/Guardian Name                                          Parent/Guardian Signature


Please send all 3 with a payment of $25 by February 23, 2017 to:

Ms. Hillman, Director of CAPA                       Forms:

Churchill High School                                      1. Registration ____

8900 Newburgh Road                                      2. Health and Emergency ___

Livonia MI 48150                                               3. T-shirt size & full workshop payment ____